Please give your advice, it would be greatly appreciated!

[FoxyRoxy21]

i am not a nurse yet, however i am hoping to get a nurses advice. my soon to be mother-in-law is currently in the hospital. over the new years holiday she was rushed to the icu due to paralysis of the vocal cords. her co2 level was in the upper eighties. as of yet they still have no answer as to what may have caused the vocal chords to stick in the speaking position. after twelve days in the icu she was transferred to a hospital closer to home. she currently is breathing through a trech and at this new hospital she is supposed to be working on physical therapy. while at this hospital she has fallen twice. both times she was in a nurse's care. since she has fallen, her ankles, hips, shoulder, and face are in pain. this now has delayed her pt......along with that she has had bowel movements while laying in bed due to the nurse not assisting her to the bathroom. yesterday, her breathing was not well due to the trech needing to be cleaned......we waited on the respiratory therapist to come in and do that, but he never showed. my soon to be sister-in-law finally cleaned/suctioned her so she could breath. when the respiratory therapist finally did come in he said, "oh what do you need me for, you got it covered," and then he left. or family is beyond frustrated please let me know what you think..... is it normal for a patient to fall in a nurse's care, or is that negligent? i can understand if it happened once but it happened twice. prior to the fall it was discovered that her blood pressure drops very low when she sits up or is standing. with knowing that do you feel there should have been more caution with having her stand to walk around?

[NurseCard, ADN]

Well, falls do happen, but for the same patient to fall twice is a little much. If ALL of the proper precautions were taken and the patient still managed to get out of bed and fall... believe it or not that does happen as well. If the proper precautions were not taken though, knowing that the patient had already fallen once, and knowing that the patient's BP dropped when she got up... well, that's pretty poor care, yes indeedy.

Letting her lay in her own poop is also poor care. If she let someone know that she had to go to the bathroom, someone should have come to assist her ASAP. If she can't talk, someone should have been checking on her regularly to make sure her needs were met, or someone should have went straight to her room when she rang her callbell.

Respiratory therapists tend to get awfully busy. Trachs get yucky stuff in them. Nonetheless, if the situation was getting emergent, as in, the thing was so full of gunk that the pt. was going into distress, and/or 02 sats were going down, the nurse should have called the RT again and let him/her know the situation was getting emergent, or perhaps even just come in the room and suctioned the trach herself. Nurses do get taught to do sterile suctioning in school, though they may rarely use the technique. I know *I* never liked to!!!

[Tweety, BSN, RN]

Respiratory Therapists don't suction and clean trachs when needed stat, nurses do. Paging RT for a suctioning was wrong.

Falls happen while in a nurse's care despite all of our best efforts and it's not negligence. If it has a bad outcome for the patient, and it can be proven that proper precautions were not implemented and documented then negligence could perhaps be proven.

Incontinence happens while waiting on nurses. Sad, but true. If the nurse refused to take her to the bathroom when she called, that's another thing. But not getting there in time could have a wide variety of reasons. As a busy, stressed out nurse, I understand this.

It sounds like there are some definate issues here. Perhaps a meeting with the manager of the unit? Good luck.

[FoxyRoxy21]

Thank you for responding so quickly! I really do appreciate hearing what you both had to say. I think that I'll make the suggestion to my family to have a meeting with the manager of the unit. I really just felt lost and like there was nothing we could do.

[Tweety, BSN, RN]

You're welcome. Good luck. Bet you anything they are short nurses and have a poor ratio. These are the kinds of things that happen under these circumstances. Getting someone to care and listen and lower ratios is like talking to a wall.

Definately complain to the manger and seek legal counsel if necessary for the negligence.

Good luck to you. The TOS does state we don't offer legal advice, so administration closing this thread wishing you well.